Healthcare Revenue Cycle Management Market Size By Product (Integrated, Standalone), By Function (Claims & Denial Management, Medical Coding & Billing, Eligibility Verification, Payment Remittance), By Deployment (On-premise, Cloud Based), By End-use (Hospitals, Physician Office, Diagnostic Labs & Ambulatory Surgical Centers), Industry Analysis Report, Regional Outlook, Growth Potential, Covid-19 Impact Analysis, Price Trends, Competitive Market Share & Forecast, 2022 – 2028

Industry Overview

Healthcare Revenue Cycle Management Market size exceeded USD 110 billion in 2021 and is expected to witness over 12.7% CAGR from 2022 to 2028. The HRCM market is anticipated to grow exponentially owing to the increasing patient admissions and growing healthcare expenditures. Also, technological advancements in HRCM solutions have surged the demand for revenue cycle management systems for efficient data management.
 

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The impact of COVID-19 on the HRCM industry is observed to be significant. The measures taken by the governments such as the lockdowns and travel restrictions proved challenging for the healthcare industry due to decreased hospital outpatient elective care numbers. Unpredictability in claim volumes as well as higher care expenditures resulted in declining income also impacted the overall market.
 

Healthcare revenue cycle management is a financial method that facilities the management of the clinical and administrative functions associated with payment, claims processing, and revenue generation. In other words, it is a strategy that healthcare providers use to pay the bills.
 

Rising data for big data analytics and its integration in healthcare revenue cycle management process will foster the market statistics

Advancements in big data analytics is expected to promote market growth over the projected timeframe as, big data analytics has the potential to improve healthcare revenue cycle management. It is a platform that can efficiently manage massive databases. The use of such software allows healthcare providers to store a vast amount of data while reducing the operational costs significantly. Big data analytics software promotes efficient data processing and analysis that aids in faster decision-making.
 

The patient service delivery process is facilitated using data processed by big data analytics and healthcare revenue cycle management technologies, that improves outcome and patient's experience. Big data analytics tools can handle massive amounts of medical data, such as major imaging examinations and genomic testing that proves beneficial for the industry progression.
 

Moreover, in recent times hospitals in developed countries are also using big data analysis and AI applications in areas of denial prediction, insurance pre-certification, and coding and billing. Such scenarios will increase its adoption amongst healthcare providers, thereby propelling the industry expansion.
 

Surging demand for integrated systems will propel the market share over the analysis timeframe

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Based on product, the healthcare revenue cycle management market is bifurcated into integrated and standalone. Out of these, the integrated segment held over USD 90 billion market share in 2021, owing to rising demand for integrated systems by large healthcare service providers. Integrated HRCM software are those that incorporates a number of applications in one product allowing data sharing between all or most modules. Integrated software’s help in daily operations, such as patient scheduling, medical billing, and electronic health record applications.
 

Integrated systems are preferred by large healthcare organizations that find it difficult to process large databases of several kinds and allows expansion to multiple locations. Thus, owing to various such advantages, interest of customers in integrated healthcare revenue cycle management solutions has surged that will foster the market forecasts.
 

Increasing awareness regarding claims & denial management will accelerate market progression

Based on function, the healthcare revenue cycle management market is segmented into medical coding & billing, claims & denial management, payment remittance, eligibility verification, and others. Among these, the claims & denial management segment held around 28.4% revenue share in 2021 and is projected to experience a higher growth rate over the analysis timeframe. Demand for claims and denial management services has increased due to rising awareness among population residing in developed countries.
 

As these denial management services are designed in order to inform people about their denials. Companies offering these services help in analysing, tracking, and implementing process improvements to eliminate recurring denials and optimize revenue. Such scenarios will surge the demand for claim and denial management systems, thereby augmenting the industry landscape.

Rising preference for cloud-based solutions in hospitals and ASCs will promote the HRCM market statistics

Based on deployment, the healthcare revenue cycle management market is bifurcated into on-premises, and cloud-based. Out of these two, the cloud-based segment accounted for over USD 84.2 billion in market value in 2021. The cloud-based software analyses revenue cycle data including transactions, accounts receivable and charges.
 

Demand for cloud-based software has surged owing to increasing utilization of cloud-based software in hospitals and ambulatory surgical centers as it is relatively cost-effective. Similarly, it offers ease of operations and is updated timely for a better user experience that accelerates the market expansion.
 

Furthermore, key players operating in the market provide cloud-based solutions. Such factors will increase its adoption over the years and will prove beneficial for the overall market size.
 

Increasing adoption of healthcare revenue cycle management solutions and services in hospitals will fuel the market size

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Based on end-use, the healthcare revenue cycle management market is divided into hospitals, physician office, diagnostic labs & ambulatory surgical centers, and others. Among them, the hospitals segment accounted for over 37% revenue share in 2021 and is expected to exhibit a significant CAGR over the forecast timeline.
 

Hospitals are one of the prominent end-users of HRCM software as they require to maintain patient databases on a large scale. Hospital revenue cycle management consists of the management, generation, and collection of patient care revenue. Hospitals use HRCM solutions to optimize revenue by enhancing management, coding, claims processing, accounts receivable, self-pay collections, and insurance follow-up that further fuels segmental demand.
 

In addition, using HRCM software’s, hospitals can the increase their net balance that further helps in achieving sustainable financial performance. Thus, increasing adoption of healthcare revenue cycle management solutions in hospitals will augment the overall market progression.
 

Increasing healthcare expenditure in North America will enhance the market expansion

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North America dominated the healthcare revenue cycle management industry and held over 47.2% business share in 2021. The growth is due to presence of supportive government initiatives that helps to improve the quality of healthcare delivery using health information technology (HIT) systems, increasing healthcare expenditure, and other factors. Surging prevalence of chronic diseases such as cancer, diabetes, and others escalate the demand for hospitalization in the region will in turn boost the need for healthcare revenue cycle management systems.
 

Similarly, high growth is owed to notable changes in regulations that have positively influenced the organization, finances, and delivery of healthcare services will further propel overall regional market statistics.
 

Ongoing innovation by leading market players have helped them capture larger market share

Some of the prominent industry players operating in the healthcare revenue cycle management market include Accretive Health (R1 RCM)  , AGS Health Inc., AllScripts, Athenahealth CareCloud Corporation, Cerner Corporation, Conifer Health Solutions, Change Healthcare (Emdeon)    , Experian Information solutions, Inc., Cognizant, McKesson Corporation, Optum (The Advisory Board Company), and SSI group among others. These industry players are implementing various growth strategies to sustain business competition and secure substantial market position in healthcare revenue cycle management industry.
 

Some of the recent industry developments:

• In January 2022, CareCloud, Inc. announced the launch of its abridged business intelligence platform, PrecisionBI Lite (PBI Lite). This platform will help to expand the company’s addressable market and extend powerful, financial analytics and business insights to small, independent practices.
   
• In February 2018, SSI Group announced a partnership with PatientPay, a payment solution providing company to create more seamless experience for billing and payments. This partnership allowed the company to enhance its revenue.
   

The healthcare revenue cycle management market research report includes an in-depth coverage of the industry with estimates & forecast in terms of revenue in USD from 2017 to 2028, for the following segments:

By Product

• Integrated
• Standalone

By Function

• Claims & Denial Management 
• Medical Coding & Billing
• Eligibility Verification
• Payment Remittance
• Others

By Deployment

• On-premise
• Cloud based

By End-use

• Hospitals
• Physician Office
• Diagnostic Labs & Ambulatory Surgical Centers
• Others

The above information is provided for the following regions and countries:

• North America
  • U.S.
  • Canada
• Europe
  • UK
  • Germany
  • France
  • Italy
  • Spain
  • Russia
• Asia Pacific
  • Japan
  • China
  • India
  • South Korea
  • Australia
• Latin America
  • Brazil
  • Mexico
  • Argentina
• Middle East & Africa
  • Saudi Arabia
  • UAE
  • South Africa